Management of critical and surgical conditions during future space exploration missions

Abstract

During future space exploration missions, management of severe medical and surgical conditions will represent a challenge. Due to severe limitations in acute care capabilities, the medical system will need to focus only on the most likely and severe conditions. Using a probabilistic approach, the primary objective of this analysis is to offer recommendations for the preparation of crews and onboard medical systems, with the aim of optimizing the medical kit while maintaining the estimated mortality risk within acceptable limits. Based on the analysis of medical literature in space medicine and analogue environments, a list of expected conditions has been established. Their incidence and average mortality in similar populations have been estimated. By balancing medical kits complexity and estimated vital risk, it becomes possible to determine which therapeutic techniques are mandatory. According to the analysis, the conditions associated with the most significant risk are severe sepsis and traumatic injuries. Besides the basicmedical procedures (intravenous access, antibiotics, oxygen...), it seems essential to be able to administer blood products or substitutes and perform surgery. The results also provide a list of conditions that could probably be excluded from the medical system due to their poor outcome, complexmanagement and extremely low estimated likelihood. The results globally correspond to the conclusions of previous publications. Like numerous spin-offs of space technologies in the past, this research is useful to increase the level of care on Earth, in particular in harsh and isolated environments.